No abstract

Particulate contamination in small volume parenteral medications has been studied and compared with that found in a selection of large volume infusions. Particle counts in 39 commonly used small volume medications and 7 large volume infusions were performed by an automated light blockage method (HIAC) or by optical microscopy. Based on these results and a random survey of drug therapy of intensive care patients, it is concluded that the contribution of intravenous medications to the total particle load received by such patients is likely to be many times greater than from infusion fluids. Until firm evidence regarding the harmful systemic effects of drug particles is available and the manufacturing regulations adjusted appropriately, final in-line filtration of infusions immediately proximal to the intravenous cannula should be considered when drugs are being given intravenously.

We examined the effects of sugar on the behavior of 45 preschool and elementary school children. Using a double-blind within-subject challenge design, we provided all children with a basic breakfast that included a challenge drink containing either 50 gof sucrose, a placebo (aspartame) of comparable sweetness, or only a very small amount of sucrose. The results indicated that high amounts of sugar caused a small increase in the children's activity level (as rated by their teachers) and a small decrement in the performance of the female subjects on a simple learning task and that sugar affected the cognitive performance of the preschoolers differently than that of elementary school children.All of these effects, however, were quite small in magnitude and were not considered clinically significant. The results did not support the view that sugar causes major changes in children's behavior.Parents and teachers often report that foods containing large amounts of refined sugar (sucrose) produce detrimental effects on children's behavior. Anecdotal reports of increased activity levels, irritability, and impairment in the ability to sustain attention and inhibit impulses are common. In addition, several articles and books written for the general public have popularized the view that sugar exerts negative effects (e.g., Duffy. 1975;Tauraso, 1983). Many of these have stated that sugar is a primary cause of attention-deficit hyperactivity disorder as it is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987) in children. In fact, according to a study by Bennett and Sherman (1983), 45% of pediatricians and family practitioners have recommended a low-sugar diet for at least some of the hyperactive children they treat. Scholarly writings have also made unfounded pronouncements regarding sugar's effects. For instance, in a comment in the American Psychologist, Buchanan (1984) labeled sugar "the most ubiquitous toxin." Only recently, however, have investigators begun to seriously examine this important issue.Unfortunately, the few controlled experiments that have been conducted have reported conflicting results. Some have shown detrimental effects of sugar on behavior (e.g., Conners &

The effectiveness of videotape feedback, as a procedure for increasing on-task behavior in a 9-year-old emotionally disturbed male, was investigated in the present study. The experimental design employed was an ABAB single subject design. Through baseline (A) and intervention (B) phase, 30 minutes of classroom behavior during a structured activity were videotaped at the same time each day. On-task and off-task behaviors from each videotaped session time were rated by trained observers for each experimental phase. The subject did not receive any feedback on his behavior during baseline (A) phases. During intervention (B) phases teacher and subject concurrently viewed a 10-minute sample of the videotape immediately following each daily videotaped session. While observing the videotape the subject recorded his own behavior. Data revealed low rates of on-task behavior during the initial baseline (A) phases. Only after introduction of the videotape feedback intervention (B) phase did the frequency of on-task behavior increase. A decrease in on-task behavior occurred with reinstatement of baseline (A) conditions. Treatment gains were partially recovered during reinstatement of videotape feedback intervention (B). Results of the present study are discussed in terms of the utility of videotape feedback as a classroom behavior management technique. Implications for self-control and further research directions are also proposed.

The aims of this study were to establish a set of standardized sensory procedures for lower extremity sensory assessment in a paediatric population, to gather preliminary data on normal sensory performance, and to derive preliminary reliability estimates. Three subtests derived from the paediatric upper extremity sensory battery under development by Cooper, Majnemer, Rosenblatt and Birnbaum (1993) were performed bilaterally on 50 healthy, school-aged children: i) pressure sensitivity and ii) directionality, on the plantar surface of the distal phalanx of the hallux, using the Semmes-Weinstein Pressure Aesthesiometer, and iii) proprioception at the first metatarsal-phalangeal joint. Neither age nor gender exerted any significant effects on the data, whereas dominance did. Cut-offs were determined separately for the dominant and nondominant halluces. Data analysis revealed good test-retest and inter-rater agreements on all subtests. These sensory subtests show promise as a standardized, reliable and therapeutically useful assessment of lower extremity sensation in children at risk for sensory impairment. RÉSUMÉLes objectifs de cette étude étaient d'établir un ensemble de procédures standardisées pour l'évaluation sensorielle des membres inférieurs d'une population d'enfants, de rassembler des données préliminaires sur le rendement sensoriel normal et d'obtenir des estimés de fidélité prélimi-naires. Les trois sous-tests effectués ont été modifiés à partir de la batterie d'évaluation sensorielle des membres supérieurs de Cooper, Majnemer, Rosenblatt et Bimbaum (1993), qui est en voie de développement. Les trois soustests suivants ont été effectués pour les deux membres inférieurs de 50 enfants d'âge scolaire en bonne santé : i) sensibilité à la pression et ii) directionalité, sur la face plantaire de la phalange distale du gros orteil à l'aide de l'esthésiomètre à pression de Semmes-Weinstein et iii) proprioception de l'articulation métatarso-phalangienne. L'âge et le sexe n'ont exercé aucune influence sur les données alors que la dominance a eu un effet significatif. Les seuils de normalité ont été déterminés séparément pour le gros orteil dominant et le gros orteil non dominant. L'analyse des données révèle une bonne fidélité de test-retest ainsi qu'une bonne correspondance entre les évaluateurs pour tous les sous-tests. Selon toute probabilité, ces tests pourraient constituer une évaluation standardisée, fiable et utile sur le plan thérapeutique pour évaluer la sensibilité des membres inférieurs chez les enfants susceptibles de présen-ter une déficience sensorielle.